LUNG INJURY/OCCUPATIONAL INJURY Flashcards
What is sepsis a result of?
Infection that gets so advanced that it causes an inflammatory response that affects the entire body.
OR toxins which are released into the body as a result of biproduct of the infection causing tissue damage to the lungs.
What is the most devastating response which can cause multi-organ failure?
Inflammatory response
How does inflammatory respond to the infection? How does the brain respond? What is it called when it affects the blood vessels going to the lungs? What does typically end up causing in the lungs?
It releases chemical that destroy tissue.
When this happens in the brain you are less responsive.
When it affects the blood vessels going to the lungs it’s commonly known as ARDS
Causing massive pulmonary edema in the lungs.
Is lactacte important? What is the relation to lactate and mortality rate?
Yes, the higher the lactate is the higher the mortality rate is.
What does a high lactate marker indicate?
There is hypoxia at a cellular level.
What is not chemically reactive and not dissolved by water and is essentially what asbestos is made of?
Silicone Dioxide, it is an incredible stable substance.
What is the consistency and structure of Abestos? What makes it different and easy to make its way down the respiratory tract?
Sand, dirt, and tiny needle-like structures
The shape of it is what makes it different.
The tiny needle-like structures are so fine that they find their way down to the respiratory tract.
What happens once Asbestos has made its way down to the respiratory tract and into the lungs? What attempt to break it down and what does it cause instead?
The body cannot break them down, macrophages try to break down the asbestos molecules but instead cause inflammation as it is never able to.
What indicated the worsening effects of the infection through the patient’s body with sepsis?
Respiratory culture
For every hour which passes without giving a patient with sepsis antibiotics what is the relationship increase in mortality rate?
10% for every hour
What does sepsis cause in the chemical release?
It causes the release of chemicals throughtou the body that damage the immune system such as the endothelial cells, capillaries, arterioles, venioles.
This in turn leaks fluid into brain, kidneys, lungs causing ARDS.
What can sepsis also cause?
ARDS & AKI
What is the hemodynamic effect of sepsis?
It dilates the blood vessels, which increases blood volume and causes blood leakage, which decreases blood volume, and demand for blood increases and goes to the lungs.
What are the treatments for sepsis?
Antibiotics and diuretics
How far can Abestos reach? How does it affect the state of the lungs?
It reaches the lower lobes
Causes scarring to the lungs and reduces lung ability to receive oxygen
How do macrophages in the lungs attempt to treat the lung from Abestos?
They try to engulf the small bits of silicone dioxide to help treat the lung.
What is the blood pressure manifestation of sepsis? And why?
Low blood pressure due to inflammation causing vasodilation which requires more blood supply to the heart.
With ARDS secondary to sepsis what is our main priority?
Keeping the patient alive for enough time to allow the body to heal itself.
While inflammation is causing vessels to dilate (leading to low BP), therefore more blood is needed to supply the heart, simultaneously fluids are leaking out of the blood through the capillaries, therefore how much initial fluid bolus is needed?
30 mL/kg
What is the very first line of tx to begin as soon as possible in septic patients?
Antibiotics and fluids
Why is lactate dumped into the body be cells? What is a worsening effect of lactic acidosis mean?
The signal that cells do not have oxygen and are working in an anaerobic environment.
Worsing of lactic acidosis equals worsening of septic shock and therefore higher chance of mortality.
When was asbestos product usage banned? How many years does post-exposure manifest any signs?
1971
30 years
What are some chronic effects of asbestosis?
Cough and chest pain
How is the pleural lining effected by absestosis? What can the worsening of the condition on the pleural lining result in?
Inflamed, and plaque builds up, restricting breathing.
The condition may progress and create mesothelioma, cancer of the pleural lining.
At what age does the risk of lung injuries go up especially due to prior work exposure?
70 years old
What effects from lung tissue scarring will cause a patient exposed to asbestos to be more susceptible to lung injury?
Loss of elasticity
What could have been a cause of the sepsis in the patient with cancer hx undergoing tx?
Central line placement
What can lead to shock seen in lactate?
Lactic acidosis
What is a sign that someone has fluid overload?
Swollen azygos vein
What is another name for coccidioidomycosis?
What is it?
“Valley fever”
It is a dimorphic fungi living in barrel soil areas of the desert
What occurs once coccidioidomycosis enters the body?
Grows in the form of year
What is the likelihood to be exposed to coccidioidomycosis while living in the desert area and what are the effects?
Most people who live in the areas where it is will inhale it at some point but it will not cause problems usually you will just feel as though you have a cold/flu.
What is the treatment for coccidioidomycosis?
fluconazole -an anti-fungal medication
What occurs in the citric acid cycle which results in the formation of lactate cells?
The improper role of glycolysis to be transformed accordingly.
*What is sepsis?
When the body works so hard to fight an infection that it over-activates the immune system.
*What does the inflammatory response to sepsis do to tissues and organs?
it harms them
*What is an uncontained hematologic system made up of?
Red blood cells
white blood cells
Platelets
Fluid phase elements
*What is the uncontained hematological system of fluid phase elements include?
coagulation factors
natural antithrombotic,
proteins of the fibrinolytic system
*What can be a cause of the uncontained hematological system affected due to sepsis
Anemia
Leukocytosis
Thrombocytopenia
Hemostatic system activation
*What can the dysfunction of hematologic organ system contribute to?
Multiorgan dysfunction
Death
*What does the inflammatory response cause?
-Leaky bloody vessels
-Major organs to lose O2 and nutrients
*What should the initial sepsis tx include as a result of leaky blood vessels?
At least 30 ml/kg of fluid followed by
*Since it is important to know where the infection originated by what should do to figure it out?
-Getting blood cultures
-Starting empiric broad-spectrum therapy w/ one or more antimicrobials to cover all likely pathogens.
*What must be closely watched in patients with sepsis? And what can be a result of elevation?
Lactate levels
Lactate elevation in sepsis is due to increased production of insufficient O2 delivery to the electron transport chain in the mitochondria.
*Where is valley fever found? and what is it caused by?
Lives in the soil in the southwestern United States and parts of Mexico and Central and South America.
Fungus coccidiosis
*What is the most common way to get valley fever?
Inhaling Coccidiosis spores that are in the air, but in most cases, the individuals that inhale coccidiosis aren’t affected.
However, those with a compromised immune system will develop a fungal infection.
